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CAMHblog > Posts > Thoughts on December 24th
  • Thoughts on December 24th
    Posted by Catherine Zahn|Dec 24, 2012

    ​The Holiday Season is difficult for many of the people we serve at CAMH, and the past few weeks must have been particularly trying.  The tragedy in Newtown, Connecticut precipitated yet another public discussion that wrongly conflated the issues of an angry, violent society with mental illness. This discourse reached an unbelievably low point when the U.S. National Rifle Association advocated for a national registry of people with mental illness, rejecting the idea that inappropriate access to military type assault weapons was a problem. 
        
    As I participate in holiday celebrations over the next week, the hurtfulness of this debate for people with mental illness and their families will be on my mind.  I was glad to see how many of us at CAMH were asked to participate publicly in the discussion and it was gratifying to hear the consistent, fact based message: most people with mental illness are peaceful, law abiding citizens. 

    While it’s true that people with psychosis may behave violently when unwell, CAMH Chief of Forensic Psychiatry, Dr. Sandy Simpson, reminded me that this contributes very little to the totality of violence in North American society and when our patients have good treatment, social engagement and a supportive environment, they have a lower risk of violent behavior than the rest of society. People with mental illness need good access to excellent care and support. 
     
    In the rare instance when violence arises from an acute mental illness, it’s a health problem. We need to help people in this situation to master their illness rather than condemn them.  They, along with everyone who has a psychotic illness, deserve a well-resourced system of mental health care with services based on recovery principles, bolstered by policies of social inclusion that reduce prejudice and discrimination.  When harm comes to innocent people, it must be acknowledged and addressed.  But, the goal is to move toward better health care, not amplified rejection and exclusion. 

    There’s no time to rest our collective voice, is there?
        

Comments:

Comments

Catherine Zahn

Margaret,

I am very sorry to hear of your son’s problems.  The frustration of being unable to help him must be overwhelming.  It looks like you’ve tried a lot of strategies, including using a legal form to get him into care and offering him rehab.  You’ve asked about whether you can ‘commit him or get him a conservatorship.’ Here is some information about going that route: http://bit.ly/ZgQWIA
 
You also mention that your son is going to court. Individuals who face charges as a result of non-violent criminal activities related to their substance abuse may have the option of Toronto Drug Treatment Court (http://bit.ly/TKWy92), a substance abuse intervention model that combines drug addiction treatment with the judicial supervision of a problem-solving court.  Individuals need to apply for this voluntary program through their lawyer and/or Duty Counsel at Old City Hall.
 
I hope you will continue to use the family support services at CAMH to help you manage this very difficult time (http://bit.ly/UmJjdd).  Someone from CAMH will be contacting you by email to follow up on this response.

Catherine
 on 1/3/2013 2:17 PM

Margaret

What to do when your son falls through the cracks??
I am desperate...for 3 years I have tired everything I can to get my son the help he needs, the latest was calling 911 yesterday, he is arrested, in court today. He could be out tomorrow.

He is 24 years old and because he is over 18 I have no rights to help him.  The last time he was picked up I refused bail just to keep him off the street, but he was out in 7 days. 

I have watched him deteriorate, he has underlying mental health problems of depression, now pshychosis, worsened by drug use.  He is a drug addict,  living on the streets.
I have previously used a  form 2 to get him into care, the trouble is he was out within 24 hours.

I have taken him to CAMH emergency, St. Josephs emergency. 
His is a drug addict who cannot make decisions for himself.
Can I commit him? Get a conservatorship?  He will die out there on the street.
I have gone to CAMH family services for counselling to understand all this, but I cannot sit back and wait for him to hit the bottom, everyone says that when he hits bottom he will ask for help.
I have offered REHAB, but he needs to sign up for it, he doesn't want to go, or he'll say tomorrow mum, tomorrow.......it may  not come
He spent Christmas eve in a drug stupor in a back alley - do I have to watch until he dies.
Desperately Fallen through the Cracks
 on 1/1/2013 12:51 PM

Catherine Zahn

Hi Deepak - when the behaviour of a seriously mentally ill patient in our forensic program is deteriorating, the hospital has to meet the challenge. The law requires that we balance providing care under the least restrictive conditions possible for the patient, while protecting that individual, other patients, their caregivers and the community from any danger associated with the patient’s deteriorating condition.  Seclusion from other inpatients is used as a treatment/management tool only when -  in the judgment of the care team - it is absolutely necessary.  We are very low users of seclusion and restraint. They are never used as punishment.

Our hospital policies governing the treatment of patients in seclusion already include reviews of any seclusion conducted by senior physicians every 72 hours, regular reviews by the hospital's professional leadership, and notification of the provincial Patient Advocate Office.
 
At the time of this case, opinion on reporting a treatment/management approach that includes seclusion  to the Ontario Review Board  if it exceeded seven days varied among psychiatric hospitals. The panel of the ORB in this case concluded that the seclusion should have been reported. CAMH will therefore report such seclusions in all cases.
 on 12/28/2012 2:31 PM

Deepak

Hi, how do you respond to the recent news that CAMH is illegally holding patients in locked seclusion for two months without notifying the Ontario Review Board, as per the Globe and Mail's December 26 article.
 on 12/27/2012 3:22 PM

Patricia Forsdyke

Often those who have stabilized after a psychosis feel enormous pain after one of these horrendous events. That being said, it is absolutely necessary to acknowledge that untreated psychosis can lead to violence. To pretend otherwise will misfire. Also families living or trying to cope with someone (who is still trapped by a psychosis and is behaving very aggresssively) are upset when the  professionals are denying that there is violence . Families are often the first to know, and are often the brunt of the aggression.

Patricia Forsdyke, Kingston
 on 12/25/2012 9:47 AM

Annick

Vibrant message, such an encouragement, yes let us have our voices heard. Thank you
 on 12/25/2012 9:05 AM

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